Volunteer Registration Form
Friday, January 12th to Monday, January 15th

Are you young at heart?
Do any of the following activities sound fun to you?

Zipline, Playing Games, Gleaning Spiritual Truths from NW Orthodox Priests, Catching up with old Friends, Supporting our Youth, Meeting like-minded Orthodox from the Northwest, Staying in a Cabin

Yes, then we need you!

We are planning an Orthodox Christian Youth Retreat for Martin Luther King Jr Weekend. Friday night before that weekend will be a volunteers' evening only. Kids arrive on Saturday, January 13th!

We need:
Cabin Counselors
Junior Counselors


Mature College Age/Young Adults may fill out the volunteer registration forms
in the pages that follow.

We hope to see you there!

Volunteer First Name
Your answer
Volunteer Last Name
Your answer
Gender
Required
Street Address
Your answer
City, State Zip
Your answer
Home Phone Number
Your answer
Cell Phone Number
Your answer
Email address
Your answer
Home Parish
Your answer
Days Available
Make sure you schedule Monday off work, if your employer doesn't include Martin Luther King day as a day off. Applicants unable to attend all three days of the retreat may not be accepted.
Position you are interested in volunteering
Volunteers may be contacted for a phone interview. Please fill in best days and times to contact you.
Your answer
A signed Priest's blessing is required to be considered a counselor.
After you hit the submit button on this registration form below you will see a link to the paperwork that needs to be printed and mailed to JoyAnn Wise.
Required
Background Check
Dear Volunteer, In an effort to keep our youth safe, the retreat committee decided to perform background checks on all volunteers. This is your notification that an inquiry to the WA State Patrol, or another agency, will be made on all volunteers.
Yes
No
Have you ever been convicted of any crime against children or other persons?
Have you ever been convicted of crimes relating to financial exploitation if the victim was a vulnerable adult?
Have you ever been convicted of Crimes relating to drugs as defined in RCW 43.43.830?
Have you ever been found by a court in a domestic relations proceeding under Title 26 RCW to have sexually abused or exploited any minor or to have physically abused any minor?
Have you ever been found in any dependency action under RCW 13.34.040 to have sexually assaulted or exploited any minor or to have physically abused any minor?
Have you ever been found in any disciplinary board final decision to have sexually or physically exploited any vulnerable adult?
Have you ever been found by a court in a protection proceeding under chapter 74.34 RCW, to have abused or financially exploited any vulnerable adult?
Do you swear under the penalty of perjury that the above information is correct?
Required
Legal Full Name
Your answer
Alias/Maiden Name
Your answer
Date of Birth
MM
/
DD
/
YYYY
Race
Your answer
Driver's License number and State
Your answer
Volunteer Agreement
Required
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